1110 Mayport Rd 2013 safety elecCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
. . . . .
13-00002439 Date
4/05/13
Property Address .
. . . . .
1110 MAYPORT RD
Application type description
ELECTRIC ONLY
Property Zoning . .
. . . . .
TO BE UPDATED
Application valuation . . . .
0
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Application desc
SAFETY INSPECTION
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Owner
Contractor
------------------------
OZI ENTERPRISES LLC
------------------------
BUDNIK AND D ELECTRICIAL CONTR
1858 S THIRD ST
6703 LAURINA PL
JACKSONVILLE BEACH
FL 32250
JACKSONVILLE
FL 32216
(904) 509-7306
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Permit . . . . . .
ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . .
90.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
10/02/13
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Other Fees . . . .
. . . . .
STATE ELEC DCA SURCHARGE
2.00
STATE ELEC DBPR SURCHARGE
2.00
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Fee summary
Charged
Paid Credited
--------------------
Due
-----------------
Permit Fee Total
----------
90.00
----------
90.00 .00
.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
4.00
4.00 .00
.00
Grand Total
94.00
94.00 .00
.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
JOB ADDRESS: _
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
0/0 Ph (904) 247-5826 Fax (904) 247-5845
jwtte 1)7a -XP0 &
JEA INFORMATION REQUIRED ON ALL PERMITS %(� 9 AMPS
NEW SERVICE U Overhead
FiResidential (Main) Service
00-100 amps 0101-150amps
Commercial (Main) Service
Lj0-100 amps ❑ 101-150amps
Conductor Type
I'Multi-Family (Main) Service
00-100 amps ❑ 101-150amps
❑Temporary Pole ❑ amps
TS 3 'PHASE
VALUE OF WORK $ Sb
❑ Underground ❑T Underground up Pole
❑ 151-200amps ❑
❑ 151-200amps 1-1
Size
F7151-200amps ❑
amps
# of Meters
amps
OCT Service amps
amps
# of Unit Meters
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps OCT Service
amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors _Qty ❑Transformers
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps
KVA 11 Motors hp
VALUE OF WORK $ --4'V6'0
REPAIRS/MISCELLANEOUS 0 /,
❑Replace Burnt/Damaged Meter Can 'Safety Inspection ❑Panel Change DOH to UG
E Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name 11no tZ Phone Number
Electrical Company Office Phone
Co. Address: % 03 /City G?Xir StateF� Zip 3,2 0�,6
License Holder (Print): /yt l j�G(diU I C, State Certification/Registration # c, , 00/ -5-R 39'
Notarized Signature of License Holder
this s
SHIRLEY L7GRAHAMof Notary
MY COIAMISSIOD 95M
EXPIRES:FebrBonded Thm Notary c Underwriters
20/